Management of Loss of Labial Cortical Plate during Immediate Implant Placement with Guided Bone Regeneration: A Clinical and Radiological Study

Background: Implant therapy has gained significant importance in rehabilitation of missing teeth in recent years. Immediate implant placement is becoming popular due to various reasons such as reduced appointments, treatment time and preservation of alveolar ridge. However, thin labial cortical plate often complicates the treatment plan in anterior region. Guided bone regeneration plays an essential role in such clinical situations. Methods: 10 immediate implants were placed in anterior region after extraction of tooth with hopeless prognosis. Guided bone regeneration using xenograft and barrier membrane was carried out to manage labial cortical plate lost during implant placement. Cortical plate thickness and bone density was measured on CBCT at baseline and 6 months. Results: Regeneration of lost labial cortical plate with complete coverage of exposed implant and formation of new bone was achieved in all the cases. CBCT showed an increase in labial cortical plate thickness with a mean difference of 1.36±0.18 mm when measured 6 months from baseline which was highly significant. It also showed statistically significant increase in bone density of new bone formed 2 mm apical to crest of alveolar bone in comparison to bone density of existing labial cortical plate at baseline with a mean increase of 525.33±138.56 HU. Conclusion: Guided bone regeneration has an imperative role in replacement of missing tooth during immediate implant placement following extraction of tooth with hopeless prognosis.